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Studies in Psychology
To cite this article: Ariel Cuadro, Alexa von Hagen & Daniel Costa Ball (2017): Procedural
differences in the calculation of the prevalence of reading difficulties in Spanish-speaking
school children / Diferencias procedimentales en el cálculo de la prevalencia del retraso lector
en escolares hispanoparlantes, Estudios de Psicología
The first source of confusion can be found in the term used to refer to
difficulties in the reading process. The opposition between the terms ‘dyslexia’
and ‘reading difficulties’ or ‘reader delays’ is the core of the so-called ‘dyslexia
debate’, as noted by Elliott and Grigorenko (2014). While the first, more restricted
term is reserved to identify reading disorders of a neurobiological origin, the
other, more broad terms include reading problems caused by social and cognitive
issues that go beyond reading processes, among others. After an extensive review
of previous literature, Elliott and Grigorenko (2014, p. 170) conclude that there is
still no consensus in the scientific community to distinguish this subgroup of
reading difficulties called dyslexia, which are originated by neurobiological
causes, from other reading difficulties caused by other factors. They therefore
recommend the use of more inclusive terms such as reading delays or difficulties
(RD), the term used in this article, which unequivocally emphasizes the central
difficulty in reading words, without demanding a definitive judgement on the
interaction of multiple causal factors, which is often impossible to resolve in
clinical practice (Elliott & Grigorenko, 2014, p. 178).
The second source of confusion focuses on the inclusion criteria used to
calculate the prevalence rate of RD. While most studies agree that RD responds
to a lack of accuracy and reading fluency (Shany & Share, 2011; Stanovich,
1992), some authors propose not to ignore lexical representation recovery diffi-
culties as a diagnostic criterion. The development of an autonomous orthographic
lexicon (Perfetti, 1995), where accurate orthographic and phonological represen-
tations of the written word are stored, facilitates the direct and fast recognition of
these words. Speed is a measure of the automation of lexicon processes (Shany &
Share, 2011) and stands out as particularly relevant for distinguishing individual
differences in lexical access (Nikolopoulos, Goulandris, Hulme, & Snowling,
2006). This consideration is especially interesting for Spanish, in which the
ambiguities in lexicalization (inconsistent spelling) require a higher level of
analysis from the subject in order to reach an autonomous orthographic lexicon;
as they may come across words that exist phonologically but not orthographically
(cielo [sky, correctly spelled]/sielo [same pronunciation, but non-existing spel-
ling]) (Cuadro & Costa, 2014; Defior & Serrano, 2014). Therefore, a measure of
orthographic representation recovery in addition to the traditional measurement of
reading fluency could allow a more sensitive diagnosis of RD, specifically for
Spanish.
The third source of confusion focuses on the procedure used to calculate the
prevalence rate. This point is illustrated especially in the great inconsistency of
results on the prevalence of RD according to the subject’s sex (higher prevalence
in men than women: Devine, Soltész, Nobes, Goswami, & Szűcs, 2013; Flannery,
Liederman, Daly, & Schultz, 2000; Liederman, Kantrowitz, & Flannery, 2005;
Rutter et al., 2004; contrary statement: Jiménez et al., 2011; Landerl & Moll,
2010; Shaywitz, Shaywitz, Fletcher, & Escobar, 1990). Hawke, Olson, Willcut,
Wadsworth, and DeFries (2009) summarize this inconsistency by reporting that
previous evidence reflects a ratio ranging from 2:1 to 15:1 for men with decoding
difficulties as compared to women identified with this difficulty.
4 A. Cuadro et al.
A more detailed look into the procedures used to calculate the prevalence rate
of decoding difficulties for each sex provides possible explanations for the contra-
diction between the results mentioned above.
For example, Share and Silva (2003) compared the prevalence of reading
difficulties of men and women, taking as an inclusion criterion a reader deficiency
greater than 1 standard deviation (SD). When this inclusion limit is calculated
from the average reading scores obtained by the full sample of both sexes, the
result indicates a higher prevalence for men (118 cases out of 914 of the entire
sample) and a lower prevalence for women (62 cases out of 914 of the entire
sample), resulting in an over-diagnosis of male participants and the lack of
identification of various female participants with reading difficulties. In contrast,
when the inclusion criterion is calculated based on the readers’ average scores for
each sex, the prevalence (92 men and 85 women with RD) is well matched,
eliminating significant differences between the two groups.
In light of the inconsistency of results and methodological differences
described in the available evidence, it is difficult to draw conclusions that quantify
the prevalence of reading delay globally and also specifically for the Spanish
language. Therefore, this study proposes a novel approach to this problem, by
analysing the prevalence of reading difficulties in a sample of Spanish-speaking
school children, comparing the results obtained from different inclusion criteria
and different ways of calculating the prevalence rate. In turn, critical variables
such as the school year and sex of the students who have been identified with RD
are addressed.
Method
Participants
A sample of 1,408 students from the second to sixth years of primary education
was assessed for this research project. Participants were native speakers of
Spanish and came from 13 private schools in the city of Montevideo, Uruguay.
The educational institutions were located in low, medium and high socio-eco-
nomic status (SES) locations (INE, 2011), but not in severe poverty areas.
Students with intellectual or other developmental difficulties which could explain
their RD as a consequence of wider cognitive difficulties were identified from
school reports and excluded from the sample. Table 1 lists the relevant demo-
graphic information.
Instruments
Reading efficiency test (Prueba de Eficacia Lectora — TECLE) (Cuadro, Costa,
Trías, & Ponce de León, 2009)
This is a speed test with a time limit of five minutes that assesses reading efficacy
by presenting 64 items. The student must complete each item, which consists of
filling in an incomplete sentence by choosing one of four words (three incorrect
and one correct). Psychometric studies reveal the one-dimensional, reliable (test-
Prevalence of reading difficulties / Prevalencia del retraso lector 5
retest reliability of .88) and valid nature of this test. The analysis of Differential
Item Functioning (DIF) yielded results of at least 6% of the items with slight
suspicion of DIF (Costa Ball, Gründel, & Cuadro, 2011).
Procedure
Both tests were applied in groups by specially trained educational psycholo-
gists. Data collection was conducted at the educational institution, in one single
session that lasted approximately 20 minutes, during school hours. The order of
the tests was the same in all instances, beginning with TECLE and ending
with TEO.
Results
The data collected were analysed following different procedures, to benefit from
the different methodological approaches used in previous studies, and to discuss
similarities and differences with previously reported evidence. Thus the first phase
of analysis considered only the reading efficiency scores (TECLE) to calculate the
prevalence. Subsequently, the second phase took the orthographic effectiveness
score (TEO) as an inclusion criterion. And finally, the third phase, focused on a
stricter definition of RD as its prevalence was then considered based on the
combination of both the diagnostic criteria listed above. With the purpose of
describing the characteristics of the students identified in more detail, different
6 A. Cuadro et al.
ways of analysing the distribution by sex and school year in each of the three
phases are proposed.
Table 2. Descriptive statistics of the reading effectiveness measure (TECLE) by school year
and sex.
School year Sex N M SD Median Asymmetry Kurtosis Min Max
Year 2 F* 158 15.58 7.51 14 1.09 3.02 1 53
M** 150 15.55 7.25 15 0.75 1.38 0 41
Total 308 15.57 7.37 14.20 0.93 2.23 0 53
Year 3 F 140 23.17 9.10 22 0.91 0.81 6 51
M 165 23.32 9.84 21 0.47 −0.38 4 54
Total 305 23.25 9.49 22.00 0.65 0.06 4 54
Year 4 F 134 30.14 10.09 28 0.56 0.23 11 62
M 139 32.52 11.04 33 0.27 −0.19 8 63
Total 273 31.35 10.63 31.00 0.42 0.06 8 63
Year 5 F 126 36.70 11.26 38 −0.01 −0.29 9 63
M 145 36.93 11.08 39 −0.22 −0.38 6 63
Total 271 36.83 11.14 38.00 −0.13 −0.36 6 63
Year 6 F 132 44.90 10.33 44.5 −0.24 −0.18 11 64
M 119 43.37 11.11 44 −0.41 −0.11 14 64
Total 251 44.18 10.71 44.00 −0.35 −0.17 11 64
Total F 690 29.41 14.14 28 0.37 −0.67 1 64
M 718 29.55 13.99 29 0.25 −0.79 0 64
Total 1,408 29.48 14.06 28 0.31 −0.74 0 64
Note: F* = females; M** = males.
Prevalence of reading difficulties / Prevalencia del retraso lector 7
Table 3. Primary students identified with RD by sex and school year in analysis
phase 1-A.
Total Female Male
School year N RD % N RD % N RD %
Year 2 308 10 3.2 158 4 2.5 150 6 4.0
Year 3 305 12 3.9 140 3 2.1 165 9 5.5
Year 4 273 12 4.4 134 5 3.7 139 7 5.0
Year 5 271 22 8.1 126 11 8.7 145 11 7.6
Year 6 251 19 7.6 132 5 3.8 119 14 11.8
Total 1,408 75 5.3 690 28 4.1 718 47 6.5
Table 4. Primary students identified with RD by sex and school year in analysis
phase 1-B.
All (N = 1,408) Female (N = 690) Male (N = 718)
School year N RD % N RD % N RD %
Year 2 308 10 3.2 158 4 2.5 150 6 4.0
Year 3 305 10 3.3 140 3 2.1 165 7 4.2
Year 4 273 12 4.4 134 5 3.7 139 7 5.0
Year 5 271 22 8.1 126 11 8.7 145 11 7.6
Year 6 251 21 8.4 132 8 6.1 119 13 10.9
Total 1,408 75 5.3 690 31 4.5 718 44 6.1
Table 6. Primary students identified with RD by sex and school year in analysis phase 2-A.
All Female Male
School year N RD % N RD Prevalence N RD %
Year 2 275 0 – 139 0 – 136 0 –
Year 3 296 1 0.3 137 1 0.7 159 0 –
Year 4 238 11 4.6 119 2 1.7 119 9 7.6
Year 5 262 24 9.2 122 6 4.9 140 18 4.9
Year 6 243 23 9.5 127 6 4.6 116 17 14.7
Total 1,314 59 4.5 644 15 2.3 670 44 6.6
Table 7. Primary students identified with RD by sex and school year in analysis phase 2-B.
All Female Male
Year N RD % N RD % N RD %
Year 2 275 0 – 139 0 – 136 0 –
Year 3 296 2 0.7 137 2 1.5 159 0 –
Year 4 238 11 4.0 119 4 3.4 119 7 5.9
Year 5 262 19 7.0 122 10 8.2 122 10 8.2
Year 6 243 23 9.2 127 11 8.7 127 11 8.7
Total 1,314 55 4.2 644 27 4.2 670 28 6.6
sex), minor differences between the total rates calculated can be seen (A: 4.5%;
B:4.2%). However, a more accurate exploration into the school children identified
by sex shows that 17 males identified by method A do not have RD in procedure
B, and 13 females who are not identified by procedure A are categorized with RD
in procedure B.
Table 8. Primary students identified with RD by sex and school year in analysis phase 3-A.
All Female Male
Year N RD % N RD % N RD %
Year 2 275 0 – 139 0 – 136 0 –
Year 3 296 0 – 137 0 – 159 0 –
Year 4 238 4 1.7 119 1 0.8 119 3 2.5
Year 5 262 12 4.6 122 3 2.5 140 9 6.4
Year 6 243 13 5.3 127 4 3.1 116 9 7.8
Total 1,314 29 2.2 644 8 1.2 670 21 3.1
10 A. Cuadro et al.
Table 9. Primary students identified with RD by sex and school year in analysis phase 3-B.
All Female Male
Year N RD % N RD % N RD %
Year 2 275 0 – 139 0 – 136 0 –
Year 3 296 0 – 137 0 – 159 0 –
Year 4 238 5 2.1 119 2 1.7 119 3 2.5
Year 5 262 12 4.6 122 5 4.1 140 7 5.0
Year 6 243 14 5.8 127 7 5.5 116 7 6.0
Total 1,314 31 2.4 644 14 2.4 670 17 2.5
Table 11. Analysis of binary logistic regression for the three phases of analysis and
procedure A and B.
Procedure A Procedure B
β ET Wald p OR β ET Wald p OR
1st phase
Year 0.26 0.08 9.06 .003* 1.29 0.30 0.08 12.13 .000* 1.35
Sex 0.51 0.24 4.42 .036* 1.67 0.34 0.24 1.99 .158 1.40
Constant −5.28 0.76 47.76 .000* 0.01 −5.01 0.75 44.39 .000* 0.007
2nd phase
Year 0.78 0.12 39.48 .000* 2.19 0.75 0.12 34.79 .000* 2.12
Sex 1.10 0.30 13.18 .000* 3.01 0.038 0.28 0.018 .894 1.03
Constant −9.51 1.08 77.34 .000* 0.00 −6.65 0.98 45.77 .000* 0.001
3rd phase
Year 0.91 0.19 21.83 .000* 2.49 0.87 0.18 22.57 .000* 2.40
Sex 1.02 0.42 5.78 .016* 2.77 0.21 0.37 0.32 .567 1.23
Constant −10.75 1.59 45.38 .000* 0.00 −8.35 1.39 36.08 .000* 0.000
Note: *p < .05.
value in procedure B. In turn, the odds ratio (OR) of each variable reports on
the advantage obtained to identify a student with RD, as it increases one level
to the next. For example, for process A, the first phase of analysis, the odds
ratio of 1.29 for the variable school year explained that for each school year
that passes, the advantage of identifying a student with RD increases 1.29
times. Respectively the odds ratio of 1.67 for the variable sex in the same
stage of analysis shows that the advantage of identifying a male with RD is
1.67 times that of identifying a female with RD.
Discussion
This study aims to analyse the prevalence rate of RD in one same sample of
Spanish-speaking school children, comparing various methods to calculate the
prevalence rate and paying particular attention to critical variables such as the
school year and sex of the students identified with RD. Three phases of analysis
are differentiated: firstly, the sole criterion for inclusion was a deficiency in
reading efficiency (RD ratio 5.3%); secondly the inclusion criterion was a defi-
ciency in the ability to recover orthographic representations (RD ratio 4.2%); and
thirdly a combination of the two previously mentioned diagnostic criteria (RD
ratio 2.4%). In all procedures used, the variable school year significantly affected
the probability of identifying a student with RD: the higher the school year, the
higher the prevalence rate. With regard to the variable sex, the two methods used
to calculate the cut-off point corresponding to the inclusion criterion of each phase
showed differences. On the one hand, when the cut-off point is calculated taking
12 A. Cuadro et al.
−1.5 SD of the mean corresponding to each school year, without categorizing into
sex (procedure A), significant differences between the number of males and
females identified with RD are observed. However, when the cut-off is calculated
involving the variable sex, taking −1.5 SD of the mean corresponding to each
school year and sex (procedure B), no differences were found in the prevalence of
RD between males and females.
Consistent with previous studies in transparent orthographies (Barbiero et al.,
2012; Müller et al., 2014), the results for this sample of Spanish-speaking primary
students reflect a prevalence rate of RD ranging between 2.2% and 5.3%.
Specifically in regard to the Spanish language, the results coincide with Jiménez
et al. (2009), who reported a prevalence rate of 3.2%, but contrast with Carrillo
Gallego et al. (2011), who noted a much higher prevalence of 11.8%. Two
possible causes can explain these differences. On the one hand, while Jiménez
et al. (2009), as in the present study, excluded children with lower IQs, Carrillo
Gallego et al. (2011) included them, thus possibly causing a higher RD prevalence
rate. Furthermore, Carrillo Gallego et al. (2011) report that the chosen cut-off
point to identify students with RD in their first phase of analysis was based on an
atypical distribution of the selected diagnostic criteria (TECLE test) because they
included data of children with other developmental difficulties, which could
explain an RD. The authors report that if they had based their inclusion criteria
on the results of a normal distribution, they would have obtained a prevalence rate
of 6.7%, which is closer to the results obtained by Jiménez et al. (2009) and also
by this study.
With regard to using three different diagnostic criteria to identify RD, it was
observed that the first phase, corresponding to reading deficiency, reflected a
higher prevalence (5.3%), followed by a somewhat lower rate (4.2–4.5%) in the
second phase, based on the deficiency of recovering orthographic representa-
tions. Finally, in the third phase, the combination of both criteria mentioned
before markedly reduced the prevalence rate (2.2–2.4%). If we categorize the
rates of each phase by school year we can see that it is only in the first phase that
students with RD are identified (3.2%) for school years 2 and 3, while in the two
subsequent phases they are either not detected (phase 2) or a very low preva-
lence rate is obtained (phase 3 — second year: 0%; third year: 0.3–0.7%). These
results could indicate that in early school years the inclusion criteria based on a
reading deficiency is the most accurate way to detect a possible RD. However,
in higher school years the diagnostic criteria based on a deficiency of ortho-
graphic efficiency or the combination of both criteria seems to facilitate a more
accurate diagnosis. Students in initial school years are just beginning the process
of acquiring orthographic representations and thus storing the orthographic
information of words that are orthographically ambiguous is slow and requires
a high level of expertise and refined orthographic lexicon for all students
(Cuadro & Costa, 2014; Lété & Fayol, 2013; Sánchez Abchi, Diuk, Borzone,
Prevalence of reading difficulties / Prevalencia del retraso lector 13
& Ferroni, 2009). Thus, the predominant use of the phonological mechanism
seems to explain individual differences in reading performance primarily in
these early school years. Only in higher school years can a more developed
autonomous orthographic lexicon be expected (Cuadro & Costa, 2014), and
consequently a deficiency in the recovery of orthographic representations can
represent a sensitive indicator of RD.
The variable school year showed a significant effect for all the procedures
used. A progressive increase in prevalence is observed as each school year
progresses. These data are consistent with the process of reading acquisition,
especially as it is described for transparent languages, as it is known that even
during the early years of their schooling children with RD achieve high levels of
accuracy, but are hindered when increasing their reading fluency, as they advance
in their schooling (Share, 2008).
On the other hand, specifically in regard to the variable sex, the results
replicate evidence obtained by Share and Silva (2003), which emphasize the
added value of calculating the selected cut-off point departing from the corre-
sponding mean of each sex and not from the total sample (procedure B). This
procedure results in a more sensitive measure to identify RD, avoiding over-
diagnosis of males and failure to identify females with RD, eliminating significant
differences in the prevalence of RD based on the sex of the students. This fact
should be considered for future prevalence studies, as well as in clinical contexts,
in order to achieve a more accurate detection of RD.
The methodology used in this study to define RD is based on the selection of
different measures of reading deficiency and corresponds to the approach used by
prevalence studies available in different languages. However, the measure of
Response to Intervention (RtI) (Fuchs & Fuchs, 2006) is gaining more and
more support as a more accurate diagnostic criterion to define RD (Elliott &
Grigorenko, 2014). In this regard, an alternative direction for future studies of RD
prevalence could be based on assessing the RtI. In addition to facilitating the
control over the differences in reading teaching practices of each educational
institution, this methodology would measure the persistence of the RD, which is
believed to be the core characteristic of specific reading difficulties (Tunmer &
Greaney, 2010).
Conclusions
The application of different procedures to estimate the prevalence of RD in one
same sample of Spanish-speaking school children resulted in a rate ranging from
2.2% to 5.3%, consistent with available evidence on transparent orthographies.
The results show that in the early school years, a diagnostic criterion based on
the measure of reader deficiency is more sensitive for detecting RD, while in
higher school years, a diagnostic criterion based on a deficiency of orthographic
effectiveness or both measures combined fulfils the same purpose.
Finally, the evidence indicates that there are no significant differences between
the prevalence of RD in females and males, if the variable sex is included to
14 A. Cuadro et al.
calculate the prevalence rate. These findings are important for future prevalence
studies as well as for the clinical setting especially to target a more accurate
identification of RD.
Prevalence of reading difficulties / Prevalencia del retraso lector 15
Método
Participantes
Una muestra de 1,408 alumnos de segundo a sexto año de educación primaria es
evaluada para el presente proyecto de investigación. Los participantes son
hablantes nativos de español y provienen de 13 colegios de gestión privada de
la ciudad de Montevideo, en Uruguay. Las instituciones educativas se ubican en
zonas de niveles socio-económicos (NSE) bajos, medios y altos (INE, 2011), pero
no de pobreza severa. A partir de los informes escolares los estudiantes con déficit
intelectuales u otras dificultades del desarrollo, que podrían mostrar un RL dentro
18 A. Cuadro et al.
Instrumentos
Prueba de Eficacia Lectora (TECLE) (Cuadro, Costa Ball, Trías, & Ponce de
León, 2009). Se trata de un test de velocidad con un tiempo límite de cinco
minutos, que evalúa la eficacia lectora a partir de la presentación de 64 ítems. El
alumno debe completar cada ítem, que consiste en la presentación de una frase
incompleta y, marca la opción correcta de cuatro palabras posibles (tres incorrec-
tas y una correcta). Los estudios psicométricos revelan el carácter unidimensional,
fiable (fiabilidad test-retest de .88) y válido de esta prueba. El análisis de
funcionamiento diferencial de los ítems (FID) evidencia resultados de al menos
un 6% de los ítems con sospecha leve de FID (Costa Ball, Gründel, & Cuadro,
2011).
Test de Evaluación del nivel Ortográfico (TEO) (Cuadro, Palombo, Costa, & von
Hagen, 2014). Se trata de una prueba de velocidad con un tiempo máximo de tres
minutos para medir la eficacia ortográfica, en términos de recuperación de la
representación de la ortografía y la fonología de palabras de ortografía incon-
sistente (ambigüedades lexicales), por medio de la presentación de 100 ítems
dicotómicos (acierto/error). El niño debe marcar la opción ortográficamente
correcta de dos palabras presentadas: una palabra es el blanco y el distractor es
la misma palabra escrita con los grafemas fonéticamente equivalentes (e.g., veso/
beso). Los estudios psicométricos indican que es una prueba de velocidad, válida
y con una fiabilidad de .76.
Procedimiento
Ambas pruebas fueron aplicadas en forma grupal por psicopedagogas espe-
cialmente entrenadas para la ocasión. La recolección de datos se llevó a cabo
en las instituciones escolares, en una sola sesión de aproximadamente 20
minutos, durante el horario escolar. En todas las instancias el orden de las
pruebas se mantuvo constante, iniciando la tarea con el TECLE y finalizando
con el TEO.
Prevalence of reading difficulties / Prevalencia del retraso lector 19
Resultados
Los datos recolectados son analizados siguiendo diferentes procedimientos, para
poder beneficiarse de los diferentes enfoques metodológicos empleados en estu-
dios anteriores y discutir similitudes y diferencias con la evidencia disponible. De
esta forma se propone una primera fase de análisis, en la cual se considera
solamente la medida de eficacia lectora (TECLE) para calcular el índice de
prevalencia. A continuación, la segunda fase toma como criterio de inclusión la
medida de eficacia ortográfica (TEO). Finalmente, en una tercera fase, se torna
hacia una definición de RL más estricta, considerando su prevalencia en base a la
combinación de ambos criterios diagnósticos nombrados anteriormente. Con el fin
de describir con mayor detalle las características de los alumnos identificados, en
cada una de las tres fases se proponen diferentes formas de analizar la distribución
por sexo y curso escolar.
Tabla 3. Escolares identificados con RL por sexo y curso en la fase de análisis 1-A.
Total Niñas Varones
Curso N RL % N RL % N RL %
2° 308 10 3.2 158 4 2.5 150 6 4.0
3° 305 12 3.9 140 3 2.1 165 9 5.5
4° 273 12 4.4 134 5 3.7 139 7 5.0
5° 271 22 8.1 126 11 8.7 145 11 7.6
6° 251 19 7.6 132 5 3.8 119 14 11.8
Total 1,408 75 5.3 690 28 4.1 718 47 6.5
Tabla 4. Escolares identificados con RL por sexo y curso en la fase de análisis 1-B.
Todos Niñas Varones
(N = 1,408) (N = 690) (N = 718)
Curso N RL % N RL % N RL %
2° 308 10 3.2 158 4 2.5 150 6 4.0
3° 305 10 3.3 140 3 2.1 165 7 4.2
4° 273 12 4.4 134 5 3.7 139 7 5.0
5° 271 22 8.1 126 11 8.7 145 11 7.6
6° 251 21 8.4 132 8 6.1 119 13 10.9
Total 1,408 75 5.3 690 31 4.5 718 44 6.1
Tabla 6. Escolares identificados con RL por sexo y curso en la fase de análisis 2-A.
Todos Niñas Varones
Curso N RL % N RL Prevalencia N RL %
2° 275 0 – 139 0 – 136 0 –
3° 296 1 0.3 137 1 0.7 159 0 –
4° 238 11 4.6 119 2 1.7 119 9 7.6
5° 262 24 9.2 122 6 4.9 140 18 4.9
6° 243 23 9.5 127 6 4.6 116 17 14.7
Total 1,314 59 4.5 644 15 2.3 670 44 6.6
Tabla 7. Escolares identificados con RL por sexo y curso en la fase de análisis 2-B.
Todos Niñas Varones
Curso N RL % N RL % N RL %
2° 275 0 – 139 0 – 136 0 –
3° 296 2 0.7 137 2 1.5 159 0 –
4° 238 11 4.0 119 4 3.4 119 7 5.9
5° 262 19 7.0 122 10 8.2 122 10 8.2
6° 243 23 9.2 127 11 8.7 127 11 8.7
Total 1,314 55 4.2 644 27 4.2 670 28 6.6
Tabla 8. Escolares identificados con RL por sexo y curso en la fase de análisis 3-A.
Todos Niñas Varones
Curso N RL % N RL % N RL %
2° 275 0 – 139 0 – 136 0 –
3° 296 0 – 137 0 – 159 0 –
4° 238 4 1.7 119 1 0.8 119 3 2.5
5° 262 12 4.6 122 3 2.5 140 9 6.4
6° 243 13 5.3 127 4 3.1 116 9 7.8
Total 1,314 29 2.2 644 8 1.2 670 21 3.1
Tabla 9. Escolares identificados con RL por sexo y curso en la fase de análisis 3-B.
Todos Niñas Varones
Curso N RL % N RL % N RL %
2° 275 0 – 139 0 – 136 0 –
3° 296 0 – 137 0 – 159 0 –
4° 238 5 2.1 119 2 1.7 119 3 2.5
5° 262 12 4.6 122 5 4.1 140 7 5.0
6° 243 14 5.8 127 7 5.5 116 7 6.0
Total 1,314 31 2.4 644 14 2.4 670 17 2.5
Tabla 10. Resumen de los escolares identificados con RL por diferentes procedimientos.
Punto de corte A* Punto de corte B**
Niñas Varones Total Niñas Varones Total
N % N % N % N % N % N %
Fase 1* 28 4.1 47 6.5 75 5.3 31 4.5 44 6.1 75 5.3
Fase 2* 15 2.3 44 6.6 59 4.5 27 4.2 28 6.6 55 4.2
Fase 3 * 8 1.2 21 3.1 29 2.2 14 2.4 17 2.5 31 2.4
Nota:
*Fase 1: 1 criterio de inclusión — déficit de eficacia lectora (TECLE);
*Fase 2: 1 criterio de inclusión — déficit de eficacia ortográfica (TEO);
*Fase 3: combinación de los 2 criterios de inclusión anteriores;
*Punto de corte A: −1.5 DT de la media total de cada curso escolar;
*Punto de corte B: −1.5 DT de la media de cada curso escolar disgregada por sexo.
Tabla 11. Análisis de regresión logística binaria para las tres fases de análisis y el
procedimiento A y B.
Procedimiento A Procedimiento B
β ET Wald p OR β ET Wald p OR
1° fase
Curso 0.26 0.08 9.06 .003* 1.29 0.30 0.08 12.13 .000* 1.35
Sexo 0.51 0.24 4.42 .036* 1.67 0.34 0.24 1.99 .158 1.40
Constante −5.28 0.76 47.76 .000* 0.01 −5.01 0.75 44.39 .000* 0.007
2° fase
Curso 0.78 0.12 39.48 .000* 2.19 0.75 0.12 34.79 .000* 2.12
Sexo 1.10 0.30 13.18 .000* 3.01 0.038 0.28 0.018 .894 1.03
Constante −9.51 1.08 77.34 .000* 0.00 −6.65 0.98 45.77 .000* 0.001
3° fase
Curso 0.91 0.19 21.83 .000* 2.49 0.87 0.18 22.57 .000* 2.40
Sexo 1.02 0.42 5.78 .016* 2.77 0.21 0.37 0.32 .567 1.23
Constante −10.75 1.59 45.38 .000* 0.00 −8.35 1.39 36.08 .000* 0.00
Nota: *p < .05.
Para resumir los índices de prevalencia obtenidos a partir de las tres fases de
análisis y los diferentes procedimientos empelados, se sintetizan los resultados en
la Tabla 10.
Se aplica un análisis de regresión logística binaria con un modelo de
predicción incluyendo a las variables de curso y sexo para cada una de las tres
fases, así como para los procedimientos A y B respectivamente. Los resultados se
visualizan en forma conjunta en la Tabla 11, para facilitar su comparación. Resulta
de especial interés observar, que en cada fase, ambas variables contribuyen de
forma significativa al modelo en el procedimiento A, mientras solamente la
Prevalence of reading difficulties / Prevalencia del retraso lector 25
Discusión
El presente estudio propone analizar la prevalencia del RL en una misma muestra
de escolares hispanoparlantes, comparando diversos procedimientos para calcular
el índice de prevalencia y atendiendo especialmente a variables críticas como el
grado de escolaridad y el sexo de los alumnos identificados con RL. Se distinguen
tres fases de análisis, tomando en primer lugar como único criterio de inclusión un
déficit en la eficacia lectora (índice de RL del 5.3%), en segundo lugar el criterio
de inclusión de un déficit en la habilidad de recuperar representaciones
ortográficas (índice de RL del 4.2%) y en tercer lugar la combinación de ambos
criterios diagnósticos nombrados anteriormente (índice de RL del 2.4%). En todos
los procedimientos empleados, la variable del curso escolar incide significativa-
mente en la probabilidad de identificar a un alumno con RL: a mayor curso,
mayor índice de prevalencia. Con respecto a la variable sexo, se obtienen dife-
rencias entre los dos procedimientos empleados para calcular el punto de corte
correspondiente al criterio de inclusión de cada fase. Por un lado, cuando el punto
de corte es calculado tomando −1.5 DT de la media correspondiente de cada
curso, sin disgregar por el sexo (procedimiento A), se registran diferencias sig-
nificativas entre la cantidad de varones y niñas identificadas con RL. Sin
embargo, cuando el punto de corte es calculado involucrando la variable sexo,
tomando −1.5 DT de la media correspondiente de cada curso y sexo (procedi-
miento B), no se encuentran diferencias en la prevalencia de RL entre varones y
niñas.
En concordancia con estudios previos en ortografías superficiales (Barbiero
et al., 2012; Müller et al., 2014), los resultados obtenidos para esta muestra de
escolares hispanohablantes reflejan un índice de prevalencia del RL, que varía
entre 2.2–5.3%. Específicamente en relación a los antecedentes en español, los
resultados coinciden con Jiménez et al. (2009), que informan una prevalencia del
3.2%, pero contrastan con Carrillo Gallego et al. (2011), que registran una
prevalencia mucho mayor, del 11.8%. Dos posibles causas pueden explicar estas
diferencias. Por un lado, mientras Jiménez et al. (2009), al igual que en el presente
estudio, excluyen a escolares con un CI descendido, Carrillo Gallego et al. (2011)
los incluyen, posiblemente provocando de esta forma una mayor prevalencia de
RL. Por otro lado, Carrillo Gallego et al. (2011) informan, que el punto de corte
26 A. Cuadro et al.
Conclusiones
A partir de la aplicación de diferentes procedimientos para calcular la prevalencia
del RL en una misma muestra de escolares hispanohablantes, se informa un
índice, que varía entre 2.2–5.3%, en concordancia con la evidencia disponible
sobre ortografías superficiales.
Los resultados reflejan, que en los primeros cursos escolares, un criterio
diagnóstico basado en la medida del déficit lector resulta más sensible para
detectar el RL, mientras en cursos más avanzados, un criterio diagnóstico basado
en un déficit de la eficacia ortográfica o en ambas medidas cumple el mismo fin.
Por último, la evidencia señala, que no existen diferencias significativas entre
la prevalencia del RL en niñas y varones, si se involucra el factor sexo para
calcular el índice de prevalencia. Resulta importante tomar en cuenta este dato en
futuros estudios de prevalencia, así como en el contexto clínico para alcanzar
criterios de identificación del RL más precisos.
Disclosure statement
No potential conflict of interest was reported by the authors./ Los autores no han referido
ningún potencial conflicto de interés en relación con este artículo.
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